A Case of Upper Mediastinal Vagus Nerve-derived Schwannoma Successfully Diagnosed by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) Using a 19-gauge Needle

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  • 19ゲージ穿刺針を用いた超音波気管支鏡ガイド下経気管支針生検法（EBUS-TBNA）で診断し得た上縦隔迷走神経由来神経鞘腫の1例

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<p>Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive and useful examination to diagnose mediastinal tumor and mediastinal lymph nodes, and the 19-gauge needle has been used recently. Case. A 51-year-old man presented to the emergency department of the hospital with abdominal pain. Chest-abdominal CT scan revealed masses in the right upper mediastinum and the right superior supraclavicular cavity. These mediastinal masses were suspected to be schwannoma based on the contrast MRI findings. EBUS-TBNA using a 21-gauge needle was performed, however the specimen was small and insufficient for histological diagnosis. Subsequently, EBUS-TBNA was performed again using a 19-gauge needle to obtain a larger specimen, and we histologically diagnosed the specimen as schwannoma. Conclusion. We diagnosed mediastinal schwannoma by EBUS-TBNA using a thicker puncture needle. Especially in cases suspected of benign disease, it is important to puncture the solid area which contains sufficient cell components, and thicker needles may be useful to obtain specimens enabling the histological diagnosis.</p>

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